The RIPT1DE Project: Exploring the Role of carbohydrate counting in the Prevalence of Type 1 diabetes and Disordered Eating

A person living with type 1 diabetes is twice as likely as someone without diabetes to develop disordered eating. Disordered eating is very dangerous for someone living with type 1 diabetes as it is often accompanied by insulin omission and/or restricted eating which can lead to diabetes complications such as cardiovascular problems and can be fatal.

People will type 1 diabetes manage their condition by calculating the carbohydrate content of a meal and adjusting their insulin dose accordingly. This is called carbohydrate counting. Carbohydrate counting is complex, and fixating on the nutritional value of food may contribute to disordered eating.
We would like to understand if this is the case, and if it is, how to best identify young people at risk of developing negative behaviours around food and eating, before they start carbohydrate counting for themselves. Carbohydrate counting often starts in adolescence, when the risk for developing eating disorders is also at its highest. We hope that intervening at this stage would prevent young people from developing disordered eating.

We want to:

understand barriers affecting eating behaviours and adherence to carbohydrate counting
find ways of understanding and assessing adherence to and adaption of carbohydrate counting
explore reasons why people might restrict/omit insulin doses or restrict/binge on food
define risks for developing disordered eating when living with type 1 diabetes
What we hope to achieve
We hope to increase our understanding of the relationships between carbohydrate counting, the psychological aspects of eating behaviour and the risk of disordered eating.

This research will pave the way to developing a new tool for assessing the risk of developing an eating disorder while living with type 1 diabetes. We would hope this new tool could help to develop a behaviour change intervention aimed at preventing negative beliefs/attitudes and associations that can start before a clinical eating disorder develops.

This research is part of a PhD project. It is being led by Karen Rigby with supervision from Dr Elanor Hinton, Professor Julian Hamilton-Shield, Dr Toby Candler and Dr Rosie Anderson.